- Alight (TX)
- …in joining a collaborative Appeals team? As an Appeals Specialist , you'll review adverse determinations for Short-Term Disability (STD) and Long-Term ... and accuracy. **RESPONSIBILITIES** + Manage the investigation of disputed Short-Term Disability (STD) and Long-Term Disability (LTD) claims, ensuring each… more
- VNS Health (Manhattan, NY)
- …to State Fair Hearings. Attends Fair Hearings in person with the Grievance and Appeals ' RN Specialist and presents arguments in defense of the appeals ... OverviewResolves grievances, appeals and external reviews for VNS Health Plans...and your loved ones, Medical, Dental, Vision, Life and Disability + Employer-matched retirement saving funds + Personal and… more
- Medical Mutual of Ohio (Brooklyn, OH)
- …will consider collective experience, training and education. . 5 years as an Appeals Specialist or equivalent experience in Medicare health insurance claims, ... and electronic inquiries in order to identify and classify appeals and grievances as outlined in policies and procedures....matching contribution. + Excellent medical, dental, vision, life and disability insurance - insurance is what we do best,… more
- VNS Health (Manhattan, NY)
- OverviewResolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long Term Care (MLTC), Medicare Advantage ... appeal decision. Develops correspondence communicating the outcome of grievances and appeals to enrollees and/or providers. Assists with collecting and reporting… more
- CDPHP (Albany, NY)
- …values and invites you to be a part of that experience. The Clinical Appeals Specialist is responsible for adhering to a member/provider appeal and grievance ... Using knowledge of clinical nursing and medical practices, the Clinical Appeals Specialist will review medical necessity requests, render determinations… more
- Baylor Scott & White Health (Temple, TX)
- **JOB SUMMARY** Hybrid position - Temple, TX The Appeals and Grievance Specialist performs reviews, within operational aspects, of the member and provider ... complaints, appeals and grievance cases for products for all lines...without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic… more
- TEKsystems (Jackson, MS)
- Revenue Cycle/ Appeals Specialist Needed Description: 100% Remote Equipment Provided The Appeals Specialist 1, under the direction of the Director of ... processes. Skills: medical claims processing, insurance claim, insurance collections, appeals , revenue cycle Additional Skills & Qualifications: -2 years of… more
- University of Utah (Salt Lake City, UT)
- …Number** PRN40045B **Job Title** Outpatient/Provider Coder Level 3 **Working Title** Medical Appeals Coding Specialist SR **Job Grade** E **FLSA Code** Nonexempt ... Coder-Hospital ( CPC -H), Certified Professional Coder-Payer ( CPC -P), Certified Coding Specialist ( CCS ), Certified Coding Specialist - Physician Based (… more
- Alameda Health System (San Leandro, CA)
- Care Management Clinical Appeals Specialist + San Leandro, CA + Finance + Patient Financial Svcs - Facil + Full Time - Day + Business Professional & IT + Req ... Coordinates and executes the appeal process for all AHS facilities clinical appeals and third party audits. **DUTIES & ESSENTIAL JOB FUNCTIONS:** NOTE: The… more
- Generac Power Systems (Waukesha, WI)
- …technology solutions company, we continue to push new boundaries. **Job Summary:** The ** Appeals and Grievances Specialist ** is a critical team player who is ... under general supervision with some guidance from leadership and higher-level Appeals and Grievances Specialists. **Job Responsibilities:** Case Resolution + Handles… more
- Robert Half Finance & Accounting (Anderson, IN)
- Description We are seeking an Appeals specialist to join our team in Anderson, Indiana. In this role, you will be responsible for managing internal and external ... appeals , collaborating with various departments, drafting response letters, and...contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to… more
- Glens Falls Hospital (Glens Falls, NY)
- …Emergency coding *Licenses, Certifications, Registrations* * o CCS, RHIT, RHIA, Certified Coding Specialist is Required o CDIP is a plus *Salary Range* The expected ... race, color, religious creed, national origin, sex, age, gender identity, disability , sexual orientation, military service, genetic information, and/or other status… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect revenue cycle support to the Revenue Cycle Managers. It is ... identified by the Revenue Cycle Managers. In addition, the Revenue Cycle Specialist is responsible for resolving all outstanding third-party primary and secondary… more
- Johns Hopkins University (Middle River, MD)
- We are seeking an **_AR revenue Cycle Specialist II_** who will be responsible for the collection of unpaid third-party claims and resolution of non-standard ... appeals , using various JHM applications and JHU/ PBS billing...claim's submission process, either electronically or by paper. The Specialist will use a comprehensive knowledge of claims submission… more
- Johns Hopkins University (Middle River, MD)
- The Department of Surgery is seeking an **_AR Revenue Cycle Specialist II_** that will be responsible for the collection of unpaid third-party claims and resolution ... of non-standard appeals , using various JHM applications and JHU/ PBS billing...claim's submission process, either electronically or by paper. The Specialist will use a comprehensive knowledge of claims submission… more
- Johns Hopkins University (Middle River, MD)
- …edits reports, file or pull EOB batches. + Identifies and escalates non-standard appeals to a higher-level specialist . + Informs the supervisor / Production ... for the basic collection of unpaid third-party claims and standard appeals , using various JHM applications and JHU/ PBS billing applications. Communicates… more
- Priority Health Care (Marrero, LA)
- JOB SUMMARY: The Revenue Cycle Specialist II must adhere to the Code of Ethical Conduct and foster positive relationships within the company, across departments, and ... response from third-party payors, processing payor denials, documentation requests, and appeals , and monitoring day-to-day activities related to appeal follow-up and… more
- Robert Half Accountemps (Los Angeles, CA)
- …service. We are now seeking a experience in Hospital Government Medical Collections Specialist with Appeals experience to join our dedicated team of ... medical care to our community. As a part of our team, the Hospital Government Medical Collections Specialist will be crucial in maintaining our high standard of… more
- City and County of San Francisco (San Francisco, CA)
- …sexual orientation, and gender identity to apply. 9775 Senior Community Development Specialist II - Program Manager The Homeownership and Below Market Rate Program ... Important Information: Classification - 9775 - Senior Community Development Specialist II - (Program Manager) Status - Permanent Civil...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more
- City and County of San Francisco (San Francisco, CA)
- …City website in the areas of homeownership programs. The Community Development Specialist also performs related duties as required. 1. Possession of a baccalaureate ... equity. Important Information: Classification - 9772 - Community Development Specialist - (Homeownership and Below Market Rate Programs) Status...to change after adoption (eg, as a result of appeals ), as directed by the Human Resources Director or… more